My Mother has been diagnosed with cancer. As difficult as that is to type, there is nothing I can do to change it. As the family nurse, it falls to me to take care of the medical side of things. I certainly have had help from my sisters, aunts, husband and daughters, but I feel the weight of wading through the best options for my Mom and trying to help guide them through decisions. Not easy, but I am grateful I have some knowledge that will help.

While I deal with this emotional stress, physical stress and life changing decision making, there are multiple bottles of narcotics sitting on the counter. As an addict in recovery, that is a very dangerous thing. Stress plus easy access. I don’t suppose I am the first person in recovery to have to deal with this. I imagine this situation has played itself out over and over again. I also imagine that at times, the addict succumbs to the pressure and takes what they shouldn’t. So, what do I do?

The first day I knew I would be alone with my Mom and the pills, I talked to my sponsor about it. I let her know what the situation was and that I was worried about cravings. I told her I didn’t have any cravings yet, which was the absolute truth (haven’t had that since spending 4 months in jail 13 years ago), but I was conscious of the fact that the stress may change that. I didn’t want to ignore that elephant in the room. That first night my sponsor texted me every hour to see how it was going. Every hour I answered that it was going fine.

I am blessed that those cravings have not returned. I am grateful to my 12 step community for helping keep it that way. I have gone to my meetings, done my readings, prayed my prayers, and stayed safe. Even better, I have been there for my Mom, Dad, daughters, sisters, aunts and everyone else effected by this diagnosis. They have also been there for me. I have been present even when it is hard, even when I break down and cry for a bit.

This is so hard. I do not like to see my Mom in pain. I am advocating for her pain control and for the best course of treatment for her. Any pain medication that is prescribed for her is for her, not me. I know that and trust that my Higher Power will continue to keep cravings at bay while I continue to do what I can for my Mom, my family and for myself. We are taking care of each other because we are a family and that is what we do. Sharing love, tears, hugs and time. We will continue to love and help each other and keep the focus on my Mom…where it should be.

You may or may not be aware of Milwaukee’s Drug Treatment Court. It started in 2009 and is designed to decrease repeat drug crimes, provide an alternative to incarceration, improve public safety, and manage limited criminal justice resources. It focuses on coordinating resources for substance abuse treatment and recovery.

Simply put, the Milwaukee Drug Treatment Court enables nonviolent felony and habitual misdemeanor offenders, with substance abuse problems, to avoid incarceration while getting help for their addiction(s). The underlying assumption is the participant’s criminal activity is connected to their addiction, and through rehabilitation they have the opportunity to end the cycle of substance abuse and drug-related crime to live a sober, crime free life.

It’s not easy to get into the program, it accepts a limited number of people a year and has tight eligibility requirements. Some of the requirements are:

Milwaukee County resident;

Age 18 or older;

Drug or alcohol dependent;

Be charged with a felony, or be a chronic, habitual misdemeanor offender;

Be facing substantial incarceration;

Meet the federal definition of “non-violent offender”;

Be amenable to the drug treatment court program.

It is a voluntary program requiring a commitment from the participant to engage in an intensive program of treatment for 12 to 18 months. Once admitted to the program, participants move through 5 phases before completion. Each phase has stringent requirements and requires completion before moving to the next phase. Some of the requirements include:

Abstinence from drugs and alcohol;

Placement in community based treatment;

Random urine drug screens and breathalyzer tests;

Reconnection with family;

Referral for special requirements such as parenting skills, anger management, and education;

Learn self-sufficiency;

Job training;

Appearance in drug treatment court once a month;

Obtain stable housing;

Aftercare and relapse prevention plan in place

Less than 30% complete this program according to the Phase V speakers I heard a couple of weeks ago. Phase V is available for continued recovery work after a participant has completed the Drug Treatment Court. The number may seem low, but I imagine the 30% that do complete the program feel otherwise. For them, this program is a lifesaver. Not only do they get help finding and maintaining recovery, but they also get a break from legal charges that can devastate a person’s future. It is a chance to start over. I am grateful for those that do have the opportunity to change the course of their life. I hope they continue to expand the drug treatment court so they can help more people. Our communities need more programs like this. If your community does not have a drug treatment court, suggest they start one. You can use Milwaukee as an example.

Drug and alcohol addiction adversely impacts families, especially children, nobody would argue that. As discussed in the article linked below, there are many ways this occurs.

There has been an alarming increase in child abuse and neglect cases as the opioid epidemic continues to progress. When an addict is consumed with getting and using drugs, everything else loses importance, even their children. Families become broken. For the ‘lucky’ children, their extended families become their caretakers, but they can grow up feeling abandoned and many develop addiction issues of their own. Where foster care placement numbers were on the decline, recent years have seen an increase that seems to parallel the rise in opioid abuse.

Those abusing substances do not make good choices, unplanned pregnancies lead to poor prenatal care which result in low birth weight and mental and physical problems. Many pregnant women fill prescriptions for opioids potentially leading to Neonatal Abstinence Syndrome (see my blog http://blog.unlikelyaddict.com/?p=163 ).

Accidental opioid overdoses in toddlers and children have skyrocketed in recent years. Too many are exposed to opioids in their homes where they are supposed to be safe. Adolescent overdose deaths are soaring as well, many of whom started using with their parents or were exposed to prescription drugs after surgery or an injury and progressed to heroin when the pills became too expensive. There is even an increase in child and teen suicide rates that some say is related to the opioid crisis.

In Milwaukee, eight children have died of opioid poisoning since late 2015, all from legal substances like methadone and oxycodone. To read more stories on this devastating topic, read here…

There has been movement on the government level to make changes to help those who are addicted. But we, as those who aren’t addicted or are recovering from addiction, need to be there for these children. We need to do everything we can to stop this epidemic and to help addicts and their children.

Stigma prevents addicts from getting the help they need. Stigma they place on themselves-“I am so worthless. Why would anyone help me?” Stigma society places on the addict-“They are junkies and thieves. Why would I help them?” Stigma the healthcare community places on the addict-“They are just drug seeking. I don’t want to deal with that.” These attitudes keep the addict stuck and the epidemic of opioid abuse growing. If we can stop, or at least minimize, the stigma associated with addiction, we can begin to slow the epidemic and eventually start to reverse the devastating effects of addiction on the addict, their families and friends, and the communities that have seen an overwhelming increase in the number of opioid related overdoses and deaths.

To do this, we must work together. As an addict in recovery, I am very open about my struggles and I take every opportunity I can to share my story. I believe this is where stigma reduction starts. With each recovering addict sharing openly about their struggle through addiction, people will begin to see addicts as people, contributing members of the community. It happens to people from all walks of life. Recovery is possible. If I can stay in recovery for 13 years (and counting), so can anyone else.

Below are some discussion points and tips on how to reduce stigma. Please read it and share it with anyone who you think may benefit from its contents.

“Shaming the Sick: Addiction and Stigma”

Stigma is defined as a set of negative beliefs that a group or society holds about a topic or group of people. According to the World Health Organization (WHO), stigma is a major cause of discrimination and exclusion. When a person experiences stigma they are seen as less than because of their real or perceived health status. Stigma is rarely based on facts but rather on assumptions, preconceptions, and generalizations; therefore, its negative impact can be prevented or lessened through education. Stigma results in prejudice, avoidance, rejection, and discrimination against people who have a socially undesirable trait or engage in culturally marginalized behaviors, such as drug use (Link, 2001).

The 2014 National Survey on Drug Use and Health found that 21.5 Americans age 12 and older had a substance use disorder in the previous year; however, sadly, only 2.5 million received the specialized treatment they needed.

Recovery Brands conducted a survey of people who use drugs, and respondents provided written reflections about what they wished people or society at large understood about addiction:

People who experience stigma regarding their drug use are less likely to seek treatment. Some healthcare providers feel uncomfortable when working with people who are dependent on drugs. It can affect their willingness to assess or treat the patient for substance abuse, how they approach him or her, and it may prevent addicted individuals from seeking healthcare altogether.

Perceived stigma can also be internalized. People who use drugs can view themselves as deviants; this can severely impact their self-esteem and self-worth. Historically, a dependence on drugs has been viewed as immoral or the result of a lack of self-control. These views contribute to stigma and present barriers to people accessing necessary treatment.

Effective ways for individuals to help reduce stigma include:

Offering compassionate support.

Displaying kindness to people in vulnerable situations.

Listening while withholding judgment.

Seeing a person for who they are, not what drugs they use.

Doing your research; learning about drug dependency and how it works.

Treating people with drug dependency with dignity and respect.

Avoiding hurtful labels.

Replacing negative attitudes with evidence-based facts.

Speaking up when you see someone mistreated because of their drug use.

This week Governor Walker signed two executive orders. The first order will create a Governor’s Commission on Substance Abuse Treatment Delivery. The commission will be made up of co-chairs of the Governor’s Task Force on Opioid Abuse, or their designees, as well as folks from the health care industry. The panel will study the feasibility of regional resource centers for addiction treatment and submit recommendations by Nov. 30.

The second order will require the state Department of Health Services to create the Governor’s Faith-Based Summit on Opioids for pastors and priests, develop best practices for police and emergency workers responding to overdoses, and develop statewide standards for data submission on people seeking addiction treatment.

So we will have another ‘committee’ that itself will cost a bunch of money while addicts continue to die at an alarming rate. We need to wait 11 months for this ‘committee’s’ recommendations about treatment facilities? Why don’t we start a treatment facility instead? We know how to treat addicts, what we don’t have is enough resources to treat them. Once their recommendations are received, how long will it take to implement them? Probably another year or more. In 2016 827 people died from opioid overdoses. How many more will die while we wait to hear what the committee says? Obviously we can’t open a treatment center overnight, but I bet we could have one open and helping people by November instead of just having some recommendations on what to do next. Let’s DO something, not wait for a bunch of politically motivated people to tell us what we might need to do.

The second order sounds great, clergy and emergency people need to know how to treat addicts when they are working with them. We need data in order to understand the scope of the problem. Those clergy and emergency responders know how to care for addicts, what they lack is a place to send them for care. Mental health hospitals are full, they often don’t have the beds to accommodate the need. So we have to send them back to where they came from, telling them to stay clean. They are given resources of course, but how many can manage to reach out for that help? Best of luck to you.

What if we had treatment facilities where we send addicts who would otherwise have gone to jail? What if we told them, “If you complete treatment, we will drop your charges, if you don’t, you will need to serve your sentence in jail”? It wouldn’t work for everyone of course, but we could collect data to see what kind of impact such a system would have on addicts. It just seems to me like we are forming committee after committee to study this and that and collect data on this and that, but not actually doing much to effect change. We need less talk and more action.

We are a society that likes to place blame. It’s not my fault, don’t blame me. So who do we think is to blame for the drug epidemic currently plaguing our country? Is it the addict? The drug dealer? Is it the doctor who prescribes too many narcotics? Maybe all of the above. It seems states are now taking aim at the drug companies that market these dangerous drugs while at the same time downplaying their addictive properties. Ohio, Illinois, Mississippi, New York, Washington, California and the Cherokee Nation have all filed suit against big pharma companies like Purdue Pharma, Teva Pharmaceuticals, and Johnson & Johnson.

Remember the lawsuits against the tobacco companies in the 90’s? They were successful. Why not try again? Who should pay the astronomical costs associated with this epidemic? Let’s hold those who make and distribute these drugs accountable for at least some of this epidemic. Sounds reasonable right? Maybe, maybe not. Either way, lawsuits such as these may force companies that make these drugs review their practices surrounding their marketing. Lawsuits, if they are successful, will undoubtedly have companies that deal with dangerous narcotics change their practices so that their addictive properties are better known. There’s a lot of money tied up in these drugs and the companies that distribute them will not change easily. Are tobacco products safer after the lawsuits? Or do they just help pay for the results of their deadly product? Will holding companies that make and market narcotics accountable help decrease the problems associated with addiction? I doubt that it will, but maybe if the amount they have to pay out in lawsuits puts a large dent in their profits, maybe they will find better ways of dealing these drugs.

There, of course, is no easy answer on who to blame. Truth be told, many of us have a part to play in the epidemic. Who do I blame for my addiction? Mostly me. I take responsibility for the drugs I took, for the pain I caused, and the laws I broke. I will not stay long in recovery by blaming others. But, as a country, we also need to take some responsibility. We need tighter controls on the distribution of these dangerous drugs. Big pharma, prescribers, drug dealers, addicts – we are all to blame. Let’s take responsibility for our piece, so we can find a solution that works.

The Opioid Commission has told President Trump to declare a national public health emergency to combat the ongoing opioid crisis. They think he is the person who can bring the required amount of intensity to this emergency. Most often this type of declaration is reserved for health emergencies, such as, most recently, the Zika crisis in Puerto Rico last year. Trump’s declaration would empower his cabinet to act boldly and focus on funding to deal with this loss of life–142 Americans die EVERY DAY from drug overdoses.

As the opioid crisis, epidemic, continues, doctors are being criminally charged when their patients overdose. Why? Because they ARE responsible when they overprescribe, when they stop caring about the person behind the prescription and just give them more pills. Is it all their fault? Of course not. But they are a part of this crisis, and I think we are starting to pull our heads out of the sand and realize there are unscrupulous doctors out there that care more for the bottom line than they do about their patients. Here are some examples…

In 2015, Dr. Hsiu-Ying “Lisa” Tseng became the first doctor to be convicted of murder for overprescribing opioid painkillers. She was sentenced to 30 years to life in prison,

The number of doctors that were penalized by the US Drug Enforcement Administration has grown more than fivefold in recent years. The agency took action against 88 doctors in 2011 and 479 in 2016. Although cases like the above are still rare, the cases are increasing. Even so, they are not the only problem prescribers. Well intentioned doctors, dentists, and other prescribers are putting dangerous drugs into the hands of patients who are becoming addicted, putting them into the bathroom cabinets of homes all over the country.

Are some doctors being falsely accused? You bet, that’s what happens in our judicial system, people are falsely accused all the time. Does that mean we stop investigating? I sure hope not.

I’m certainly not saying opioids should never be used. But I am saying that we need to be very careful about how we are using them. We need better alternatives to pain management. We need insurance to cover those alternative options. We need to try those alternatives FIRST, before opioids. Or, at least, use opioids short term while waiting for alternative options. We need to become fully aware of those doctors that run pill mills, and stop them. We need to continue to educate prescribers and patients on the dangers of these drugs. We need to increase the help that is available to addicts. We often hear about the addicts that succumb to the disease, how about we start to focus on the success stories so that people who are struggling know there is hope. There are those of us who have fought the disease of addiction and won, and continue to win-one day at a time.

Fox 6 News reported Saturday June 10th that the Milwaukee County Medical Examiner announced they have responded to 12 probable drug overdoses in the past 72 hours. They don’t say whether or not these were fatalities, but since the medical examiner is involved I suspect they are. The announcement comes after Milwaukee County said they are preparing for a new high of overdoses in 2017. The number could exceed 400 people, according to the medical examiner’s office.

What is killing these people? Among other things, a drug, carfentanil. What is carfentanil? It is a synthetic opioid used to sedate animals as large as elephants. It is 10,000 times more potent than morphine and 100 times more potent than fentanyl (which itself is 50 times more potent than heroin). It is responsible for overdose clusters all across the country. Why in the world would people take something that would almost certainly kill them? Well, the answer is they don’t realize they are taking it. Often it resembles powdered cocaine or heroin and is sometimes mixed with those drugs to strengthen their impact. Users are not told and frequently die as a result.

Naloxone, or Narcan, can reverse carfentanil if given immediately, just as it does for other opioids, but it may take several doses.

Where does it come from? It is marketed under the trade name Wildnil as a general anesthetic or tranquilizer for large animals. It is NOT approved or safe for use in humans. It’s produced clandestinely in Mexico and China. It was first discovered last summer in Akron Ohio. Within a month that city saw 236 overdoses due to carfentanil and 14 of those people died. It has spread to many more states since then.

The drug is so deadly that its appearance prompted the DEA to issue a warning to police and the public in September last year. Just handling the drug can be deadly, a small bit of powder, absorbed through the skin of a non-user (like police or fire fighters), can cause an overdose and death within a very short period of time.

As a society, we are too quick to use opioid pain relievers. They certainly have their place, but in this world where a pill will cure whatever ails you, when a patient complains, too often, the prescriber prescribes opioids. How many prescribers actually suggest alternatives to their patients? How many insist their patients try alternatives BEFORE writing an opioid prescription?

This may be changing as the opioid epidemic grows more out of control. Earlier this year The Department of Health and Mental Hygiene announced that it was instituting new rules for prescribing opioids to Medicaid patients. The American College of Physicians announced new guidelines for treating lower back pain, one of the most common reasons for doctor visits, with therapies such as massage, spinal manipulation or acupuncture, rather than drugs.

Prescribers should consider opioids the LAST resort instead of the first. But for those prescribers who do try to get their patients to agree to try something different, it can be difficult to get them to agree to try alternative treatments. These types of treatments may require repeated visits to a practitioner’s office and can be physically uncomfortable, tedious and expensive; taking a pill is easier. The results are not seen as quickly and patients don’t want to ‘work’ for pain relief. There, of course, is the added problem that some insurance companies don’t cover some of the alternative treatments such as acupuncture.

After some research, I have compiled a list of more common alternative treatments with a brief description of each. I do remember an experience that occurred when I worked for a doctor who was trained in acupuncture. I got a call from one of his patients that had “thrown out his back”, he asked if the doctor could see him for acupuncture. The doctor readily agreed and a short time later the patient hobbled into the office. He could barely walk. The treatment took about 30-45 minutes after which the man came out walking upright and without difficulty. He said he felt like dancing. I may not have believed it if I hadn’t seen it myself. Acupuncture really works. So do acetaminophen and NSAIDs. When I was addicted to opioids, I would never have considered these as true pain relievers. Sure they worked for the occasional mild headache, but for real pain I needed real drugs. I was amazed to discover, after surgery shortly after getting clean from opioids, that acetaminophen was effective for my surgical pain. Again, I would not have believed it if I hadn’t experienced it.

As with any treatment, patients should make sure that the practitioner has appropriate training and experience. But as a medical community, let’s try something new, or not so new. Let’s stop using these addictive and dangerous drugs to treat things that could be managed with less threatening treatments. Let’s just try…

Over-the-Counter Acetaminophen

Acetaminophen, the active ingredient in Tylenol, is another common and effective pain reliever. It is recommended as a first-line of treatment by the American College of Rheumatology.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

These are more potent than acetaminophen, but also available in over-the-counter dosage. Higher doses can be taken with a prescription. NSAIDs include anti-inflammatory drugs, such as Motrin and Aleve. The downside to these drugs, for older patients, is risk of organ toxicity, kidney or liver failure and ulcers.

These anti-depressants are appropriate for treating nerve, muscular and skeletal pain. Anti-depressants can also help people sleep. They offer help without the side effects of opioids.

Neurostimulators

This treatment uses implanted electrodes to interrupt nerve signals. This does not cure what is causing the pain, but stops the pain signals before they reach the brain. It can be used for back, neck, arm, or leg pain. Trials are currently underway to test their effectiveness on headaches.

Anticonvulsants

Traditionally used to treat epilepsy, anticonvulsants can also relieve neuropathic pain by suppressing pain signals from the brain.

Injections

Arthritis, injuries, muscle pain, and headaches are among the kinds of pain treatable with injections. Types include nerve, trigger point, radiofrequency, and epidural injections.

Physical Therapy

This requires more work from the patient (attending sessions as well as following up at home with recommended exercises) but is often essential to improving physical healing and relieving pain long-term.

Spinal manipulation

Also called spinal manipulative therapy or manual therapy, combines moving and jolting joints, massage, exercise, and physical therapy. It’s designed to relieve pressure on joints, reduce inflammation, and improve nerve function. It’s often used to treat back, neck, shoulder, and headache pain.

Massage, Acupuncture and Chiropractic Care

Some report these methods are just as effective, if not more effective, than medications. Plus, they are safe and free of side effects.

Exercise

Doctors recommend exercise to all patients, but research has shown that it is especially important for those with chronic pain. Low-impact exercise helps improve mobility and functionality. Studies have shown that chronic back pain, joint pain, arthritis, and fibromyalgia can all be improved with yoga and tai chi.

Aromatherapy

For most people, the idea of smelling something to make you feel better may sound a bit silly, at best. But aromatherapy has been used for pain management since the time of the ancient Egyptians. Peppermint oil, lavender oil, chamomile oil, and African marigold oil have been used for pain management ever since.

Hypnotherapy

Hypnotherapy is an alternative practice where a licensed hypnotherapist guides your mind to a highly focused mental state.

Herbs

Natural pain treatments include herbal medicines—plants that are used to treat health problems including pain management. The seeds, berries, roots, bark, leaves, and flowers of plants have been used as medicine long before recorded history. Many modern day pharmacological medicines are based off herbal remedies.

~Capsaicin: Derived from chili peppers, capsaicin has been known to reduce the pain sensation to the central nervous system.

~Ginger: The phytochemicals in ginger have been known to reduce inflammation.

~Turmeric: The active ingredient in turmeric, curcumin, has been known to reduce inflammation and pain.

Medical Marijuana

Medical marijuana is a controversial, non-opioid alternative for pain. More and more states are passing laws allowing medical marijuana use for conditions such as pain, headaches, nausea, seizures, and Crohn’s disease.

Radiofrequency ablation

In this procedure, which was first used in 1931, a physician uses electric currents to decrease pain signals from a specific nerve.

Mindfulness

The practice of acknowledging the present moment and accepting one’s feelings — can be a great benefit to patients with chronic pain. Many patients spend much of their time in pain or worrying about when it will come back, and mindfulness helps them accept their situations and can reduce the intensity of pain

Cognitive Behavioral Therapy

Many people with unrelenting chronic pain can feel hopeless. Cognitive behavioral therapy can help them practice “acceptance theory,” which can lead to changed behaviors and perceptions, and increase a patient’s’ confidence and self-efficacy for managing pain.

Having an exit plan

An article in the Journal of the American Pharmacists Association, Opioid exit plan: A pharmacist’s role in managing acute postoperative pain, found that “[A] hospital pain management team operating a pharmacist-led opioid exit plan (OEP) can be key to guiding the appropriate prescribing practice of opioids and assisting with transitions of care on discharge.” Genord and coauthors see OEP as a tool that has the potential to “expand the role of pharmacists in managing acute pain in postoperative patients.”

Enhanced recovery

Some hospitals are changing the way they address pain during surgical procedures. Patients are administered less addictive pain medication before and during surgery to reduce recovery time and complications. In one example, patients are given three non-addictive painkillers before his surgery to reduce pain and sensation. Then a nerve block is placed in the surgery area during the procedure to more directly target the pain. Other changes include, no longer requiring patients to fast or remain on bed rest for several days after surgery, and giving patients large amounts of IV fluids. The medical community believes these common surgical protocols can cause more harm than once thought.

Neonatal abstinence syndrome, or NAS, occurs in newborns exposed to opiate drugs while in the mother’s womb and can cause withdrawal symptoms after birth. This is not a new problem of course, but it is increasingly common. As the problem of opiate addiction grows in this country, so does NAS.

NAS was first defined in the 1970’s. Recently there has been a dramatic increase in the number of cases. In 2012, the syndrome was diagnosed in 21,732 infants in the United States. Every 25 minutes, 1 baby is born suffering from opiate withdrawal.

The graph below shows the spike in recent years.

In Wisconsin, the state Department of Health Services says that in 2015 598 babies were born addicted and suffering from NAS compared to 142 in 2006.

The most common abused opiates (also known as opioids) resulting in NAS are hydrocodone (Vicodin) and oxycodone (Percocet, OxyContin), the most common illicit substance is, of course, heroin.

Babies with NAS are more likely than other babies to be born with low birthweight (less than 5 pounds, 8 ounces) and they usually have to stay in the hospital longer after birth. Symptoms show up 48-72 hours after birth and vary depending on the level of abuse in the mother and the drug abused. Symptoms can include the following…

Medication similar to the drug used during pregnancy, most commonly with either oral morphine solution, methadone or buprenorphine

Phenobarbital for seizures

Higher calorie formula because these babies need more calories to grow

Things to help soothe the baby such as, swaddling, keeping the room dim and quiet, holding the baby with skin to skin contact (kangaroo care)

The average length of stay for most babies that get treatment is 17-23 days.

In 2012 10% of women filled an opioid medication prescription during pregnancy. Detecting opiate use or abuse during pregnancy and treating it before delivery improves the treatment course for the newborn. When women were treated during pregnancy, their newborns required 89% less morphine and had a 43% shorter hospital stay. But to detect it requires women to report their use or submit to a drug screen. Those with a serious problem would of course be reluctant to do that. Are we at a point that we require all pregnant women to have drug testing? Should we make it a standard test for pregnant women? Maybe. But if we do that, some women may instead decline to get prenatal care at all which could make the problem worse.

Prevention is key. Education for women of childbearing age and prescribers on the risks of NAS is of the utmost importance. If we can decrease the incidence of opiate abuse in the general public, we will decrease the incidence of NAS.

So when we fight against this addiction, either as individual addicts or as the public, we are not only fighting for people with addictions, we are helping those innocent babies. The smallest of victims. Those that can’t help themselves.